Search the hub

Cancer services at large hospital trust have been at ‘catastrophic’ risk of being overwhelmed, after two of its hospital sites had to suspend life-saving cancer surgeries in the last month due to COVID-19. In its latest board papers Mid and South Essex Foundation Trust rated the “cancellation of cancer elective activity” at its highest risk level of 25 – which based on their own risk-scoring key is “catastrophic”. It said the expected consequences at this risk level include “permanent disability or death, serious irreversible health effects” and an “unacceptable… quality of service”. The trust runs three general acute hospitals in the county. Its 2,000 plus beds make it the third largest trust in England after University Hospitals Birmingham FT and Leeds Teaching Hospitals. The same board papers, dated 28 January, said cancer surgery at Southend University Hospital, one of three hospital sites run by the trust, “ceased on 24 December”. At a second hospital site, Mid Essex Hospital covid “hit hard just before Christmas” and elective work was “dramatically impacted with short period of life and limb only carried out on site”. This meant all P2 cancer surgery — which requires treatment in less than four weeks — did not take place. Both hospital sites said they hoped the independent sector could help them restart cancer surgeries this month with a focus on “long waiting and clinical urgent patients”. It is not clear how much capacity the sector has to work through waiting lists and the board papers said “some of this capacity may be reduced” because of recent changes to a new national contract for the independent sector. Read full story (paywalled) Source: HSJ, 29 January 2021

There were 800 fewer cancer surgeries in the first two weeks of January than usually take place during the period, according to provisional data seen by HSJ. The bulk of this reduction came in London and the surrounding counties such as Essex, Bedfordshire, and Surrey. London and the south east have been severely hit by coronavirus pressures, causing widely reported mass cancellations of non-urgent elective surgery. However, the impact on cancer cases has, so far, been less clear. NHS England has insisted in the last week that urgent cancer cases should be given the same priority as coronavirus patients. Read full story (paywalled) Source: HSJ, 25 January 2021

The UK’s main gender identity development service for children is leaving thousands of vulnerable young people at risk of self-harm as they wait years for their first appointment, according to a highly critical report. The Care Quality Commission (CQC) took immediate enforcement action against the Tavistock and Portman NHS foundation trust when it completed the inspection in November, which rated the service overall “inadequate” and highlighted overwhelming caseloads, deficient record-keeping and poor leadership. The commission, which heard from young people using the service, parents, carers and staff in the course of its inspection, told the trust that services and waiting times in the Gender Identity Development Services (GIDS) in both their London and Leeds clinics “must improve significantly”, demanding monthly updates on numbers on waiting lists and actions to reduce them. The service has faced major scrutiny in recent years, with some former staff and campaigners raising concerns about the “overdiagnosing” of gender dysphoria, the consequences of early medical interventions and the significant increase in referrals of girls questioning their gender identity. Read full story Source: The Guardian, 20 January 2021

Nearly a quarter of a million people have been waiting more than a year for operations and other hospital procedures, HSJ has learned. Official NHS England data for November, released on Thursday, showed 192,000 patients had been waiting for treatment for more than a year. However, figures leaked to HSJ of weekly data up to 3 January showed a steep increase to 223,000 patients — the highest reported so far throughout the COVID-19 pandemic and before. According to the leak, just under 4.2 million people are waiting for treatment, of which year-long waiters comprise 5.4%. The data also showed 175 patients across England had waited more than two years for treatment. In February, before the pandemic, 1,613 patients were waiting more than a year — meaning there has been a 138-fold increase. Read full story (paywalled) Source: HSJ, 15 January 2021

The NHS faces a mounting beds crisis as care homes suffering unprecedented staff shortages are forced to stop taking patients from hospitals, health and care leaders have warned. Ministers are desperately trying to free up space in the NHS to tackle a backlog of 5.6 million people – equivalent to almost 10% of people in England – awaiting treatment. But efforts to speed up the discharge of hospital patients into the community are being hampered by care worker shortages. Britain’s largest not-for-profit care home provider, MHA, has already had to close 1 in 10 of its homes to admissions from hospitals, its chief executive, Sam Monaghan, told the Guardian. The warning comes as a comprehensive assessment on Wednesday reveals that care homes in England are facing the biggest staff shortage on record, with 105,000 positions unfilled according to the 2021 State of the Adult Social Care Sector and Workforce report by Skills for Care, an industry body. Read full story Source: The Guardian, 13 October 2021

The percentage of patients visiting A&E who are seen within four hours has hit a “terrifying” new low in Scotland, latest figures show, with ministers urged to “get a grip” on the growing crisis. The figure has been declining since the summer amid high demand, staffing shortages and a lack of patient flow through hospitals. In the week to 3 October, just 71.3% of patients were seen within four hours, a five percentage point drop on the previous week, according to a data published by Public Health Scotland. The figure is the lowest since records began in 2015, with the Scottish Government target set at 95%. With 25,000 visits to A&E in that week, it means more than 7,000 patients waited longer than four hours. Some 1,782 people waited more than eight hours, while a record 591 patients waited longer than 12 hours. Last week, Scotland’s Health Secretary, Humza Yousaf, warned that Scotland’s NHS faces an “incredibly difficult winter” despite announcing a £300 million funding boost. But opposition parties have now accused him of “overseeing a scandalous situation” and leaving A&E departments “beyond breaking point”. Read full story Source: The Scotsman, 12 October 2021

Dr Katherine Henderson, a senior A&E consultant in London and President of the Royal College of Emergency Medicine, says physical and verbal attacks have increased in recent months. Speaking to the Guardian, she says: “It is a sad reality that in recent months there has been a rise in abuse directed towards healthcare workers, but this abuse is not something new to frontline staff or emergency departments. It was bad before the pandemic, but there’s a changed atmosphere now. “During the pandemic people were being very positive about healthcare workers. But now the public are frustrated that services aren’t getting back to normal. Maybe people who weren’t the source of abuse before are now being the source of abuse. Abuse may be physical or verbal, it may be through social media, or it may be racial or misogynistic. “People are being angry – very angry – with us. They are angry about long waits, about having to stand outside emergency departments in queues, about delays in ambulances coming, including to take their relative home from hospital. The public haven’t really caught up with how struggling the whole NHS is." Read full story Source: The Guardian, 10 October 2021

One in 10 posts for consultant psychiatrists in England are vacant with growing waiting times for people needing mental health treatment, experts have warned. A census of the current situations across England by the Royal College of Psychiatrists has found there is just one psychiatrist for every 12,567 people in England. Health service bosses at NHS England have acknowledged there are an estimated 1.5 million people who are waiting for mental health support amid fears the situation will worsen as the effects of the Covid pandemic become clear. This is on top of the 5.6 million patients waiting for routine operations and treatments for physical illness. The Royal College said there was a shortage of 568 empty consultant posts in the NHS out of a total of 5,367 which it said meant patients would have to wait longer for treatment. In total there are 4,500 full time consultants working in the NHS. The highest rates of unfilled positions are in the fields of addiction, eating disorders and child and adolescent psychiatry. Read full story Source: The Independent, 6 October 2021

Patients are starting to suffer because health and care workers are unable to purchase fuel. The fuel crisis is starting to have an effect on the care of vulnerable patients, community and mental health service providers have warned. Many petrol stations are running short of fuel as a result of panic buying, after the oil firm BP warned that it would have to close some of its petrol stations because of the lack of lorry drivers. Currently there is a shortage of about 100,000 HGV drivers. Crystal Oldman, chief executive for the Queen’s Nursing Institute, which represents community nurses, told the journal HSJ that the fuel shortage was already affecting them: “This potentially means nurses cannot get to the patients they need to if they are unable to access fuel. At the very least, it will mean more time searching for petrol stations that have a supply, taking valuable time from their working day and more unpaid overtime will be undertaken as nurses will always prioritise their patient care.” Patient transport has also been affected. A source at a patient transport provider in the West Midlands told HSJ that it had been “a bit of a nightmare”. The provider had had to turn down a request for a patient going to London because of the fuel shortage and because of climate protesters disrupting motorway transport: “Ultimately those patients are either at home and distressed carrying a big risk in the community or [accident and emergency] departments which [are not] the right settings.” Read the full article here Source: Future Care Capital

Covid has created an urgent need, and a unique opportunity, to get the true waiting list out in the open. The English waiting list continues to break new records in the aftermath of Covid, and even the Secretary of State says it could reach 13 million patients. But the referral-to-treatment data – bad as it is – doesn’t reveal the full scale of the backlog, partly because not all waiting lists fall under RTT rules, but also because the RTT waiting list data is inaccurate and incomplete. The scale of these hidden delays could be vast - millions of patients. Some could wait for years, some indefinitely, always taking second place to the swelling RTT waiting list and the targets that surround it. Some patients who need urgent care will end up with disability or death. Others are already in terrible pain. All deserve better. Read full article here Source: HSJ (Paywalled). 20 September 2021

Hospitals in England have been given the green light to ease some of the Covid infection-control measures that have been in place during the pandemic. The changes, recommended by the UK Health Security Agency (UKHSA), are aimed at easing pressure on the NHS. It says testing and isolating patients before planned operations can be dropped and hospitals can return to normal cleaning procedures. Social distancing can also be reduced from 2m (6ft) to 1m in some areas. UKHSA chief executive Dr Jenny Harries said the new recommendations would help local hospitals plan more elective care. "This is a first step to help the NHS treat more patients more quickly, while ensuring their safety and balancing their different needs for care," she said. Health and Social Care Secretary Sajid Javid said: "As ever more people benefit from the protection of our phenomenal vaccination campaign, we can now safely begin to relieve some of the most stringent infection controls where they are no longer necessary, to benefit patients and ease the burden on hardworking NHS staff." Read full story Source: BBC News, 28 September 2021

The NHS backlog is being disproportionately shouldered by people in poorer areas, according to new research, amid a stark warning that waiting lists are likely to “grow significantly” because millions of people did not seek help during the pandemic. Waiting lists for routine treatments have grown by 50% in the most deprived parts of England, compared with nearly 35% in the most affluent areas. Those in deprived areas were also nearly twice as likely as those in the wealthiest to wait more than a year for treatment, according an analysis by the King’s Fund. Jonathan Ashworth, the shadow health secretary, warned that the long waiting lists were in danger of leading to privatisation of the NHS. “Waiting times have got so bad that you’ve got people taking out payday loans, sometimes even remortgaging their homes, because they cannot bear the pain, or the disruption to their lives, or fear they will lose their lives,” he said. “That is eroding the fundamental universal system that we created.” Read full story Source: The Guardian, 27 September 2021

"To be put in a position where you're basically begging off people, it's infuriating." Last October, 12-year-old Hayden Kildea was diagnosed with severe scoliosis, a condition where the spine twists and curves to the side. Left untreated, it can become a dangerous and life-limiting condition. The Kildeas, who live in Strabane, Northern Ireland, say they were told Hayden would need urgent surgery - but that because of the backlog caused by the pandemic, he would have to wait more than two years. His mum Shauna found a clinic in Turkey that was able to carry out the operation immediately, but it would cost £50,000 - money the family didn't have. So in the summer, they turned to crowdfunding and campaigning to raise the money. Millions of people across the UK are currently on NHS waiting lists - in Northern Ireland there are over 465,000 people, while in England, 5.6m are queuing for treatment. Data shared with BBC Panorama shows that on average, waiting lists have grown by 50% in the most deprived parts of England since the start of the pandemic, compared with nearly 35% in the most affluent areas. The research, conducted by the King's Fund, also shows that people on waiting lists in poorer areas are nearly twice as likely as those in wealthier areas to wait more than one year for treatment. The Health and Social Care Board in Northern Ireland said patient demand continued "to exceed capacity across a range of specialties". It added: "As a result, even before the pandemic, the number of people waiting longer than the target waiting times was increasing." Read full story Source: BBC News, 27 September 2021

It could take more than a decade to clear the cancer-treatment backlog in England, a report suggests. Research by the Institute for Public Policy Research (IPPR) estimated 19,500 people who should have been diagnosed had not been, because of missed referrals. If hospitals could achieve a 5% increase in the number of treatments over pre-pandemic levels, it would take until 2033 to clear the backlog. However, if 15% more could be completed, backlogs could be cleared by next year. Between March 2020 and February 2021, the number of referrals to see a specialist dropped by nearly 370,000 on the year before, a fall of 15%. Behind these figures are thousands of people for whom it will now be too late to cure their cancer, the report, with the CF health consultancy, warns. And it estimates the proportion of cancers diagnosed while they are still highly curable - classed as stage one and two - has fallen from 44% before to pandemic to 41%. IPPR research fellow Dr Parth Patel said: "The pandemic has severely disrupted cancer services in England, undoing years of progress in improving cancer survival rates. "Now, the health service faces an enormous backlog of care, that threatens to disrupt services for well over a decade. We know every delay poses risks to patients' chances of survival." Read full story Source: BBC News, 24 September 2021

Scotland's Health Secretary Humza Yousaf says the NHS is facing the "biggest crisis" of its existence. There's a shortage of beds, the demand for ambulances is soaring and waits in accident and emergency departments are getting longer. On top of that, COVID-19 admissions have been rising fast as the number of infections in Scotland spiralled at the end of the summer. BBC News share five charts illustrating the enormous pressures currently being felt by NHS Scotland. Read full story Source: BBC News, 23 September 2021

The use of opioids for pain relief soared during the pandemic as some patients waited longer for surgery, according to new research. The University of Aberdeen team focused on more than 450 patients due to have hip or knee replacement surgery. They said waiting times for these procedures increased by an average of 90 days and that the numbers of patients using opioids while waiting for surgery increased by 40% compared to pre-pandemic levels. The research, published in the BMJ Quality and Safety, looked at data collected from 452 NHS patients from the north east of Scotland. The university's Luke Farrow, who led the research, said alternative ways of managing severe arthritis pain needed to be found "urgently" for those waiting for this kind of surgery. Read full story Source: BBC News, 15 November 2021

Surgical hubs, new technology and innovative ways of working will help tackle waiting lists and treat around 30% more elective care patients by 2023 to 2024. Backed by a new £36 billion investment in health and social care over the next 3 years, ‘doing things differently’ and embracing innovation will be the driving force to get the NHS back on track. The funding will see the NHS deliver an extra 9 million checks, scans and operations for patients across the country, but it’s not enough to simply plug the elective gaps. The NHS will push forward with faster and more streamlined methods of treatments. Surgical hubs already being piloted in a number of locations, including London, are helping fast-track the number of planned operations, including cataract removal, hysterectomies and hip and knee replacements, and will be expanded across the country. Located on existing hospital sites, surgical hubs bring together the skills and resource under one roof while limiting infection risk and providing a COVID-secure environment, with more planned to open in the coming year. The NHS has been trialling a range of new ways of working in 12 areas, backed by £160 million, to accelerate the recovery of services. This includes setting up pop-up clinics so patients can be treated quickly, in person, and discharged closer to home, as well as virtual wards and home assessments to allow patients to receive medical support from the comfort of their home, freeing up beds in hospitals. GP surgeries are using artificial intelligence to help prioritise patients most in need and identify the right level of care and support needed for patients on waiting lists. The latest cancer tests being deployed across the NHS are also helping speed up diagnosis and spot cancer early on. Thanks to the hard work of staff, a quarter of a million people were checked for cancer in June – the second highest number on record – and more than 27,000 people started treatment for cancer in the same period. Professor Steve Powis, NHS England medical director, said: "Although the pandemic is still with us and we will have to live with the impact of COVID for some time, the NHS has already made effective use of additional resources to recover services. From adopting the latest technologies to more evening and weekend working, NHS staff are going to great lengths to increase the number of operations carried out. The further funding announced this week will support staff to deliver millions more vital checks, tests and operations, so if you have a health concern, please do come forward to receive the care and treatment you may need." Read full story Source: 8 September, Department of Health and Social Care

According to reports, more than half of patients waiting for a first consultant appointment in Northern Ireland are still waiting longer than a year. Health Minister Robin Swann has apologised for the long waiting lists, with the Royal College of Surgeons describing the figures as "devastating". Data has revealed 348,867 people are currently waiting for a first appointment, with fifty-three percent (184,873) found waiting 52 weeks or more. "It's not where we want them to be - we don't want people waiting that long because it actually increases demand on our health service the longer people are waiting. This is about changing the direction of the underinvestment, not just in the health service but also in our workforce, so it takes time." Said Mr Swann. Read full story. Source: BBC News (Northern Ireland), 26 August 2021

According to recent reports, the number of patients on waiting lists for non-urgent hospital treatment in Wales has again hit record levels. Data has revealed there were 624,909 people waiting in June, and those waiting the longest, more than nine months, rose again to 233,210. A Welsh government spokesperson said: "Waiting times for treatment continue to grow. However, it is encouraging to see progress being made with the number of patients waiting over 52 weeks falling for the third month in a row. We also saw the largest number of specialist consultations completed and treatments started in any month since the start of the pandemic." A&E time performance has been at its worst on record, with 94,176 attendances to emergency units over the month. Health spokesman Russell George said: "To record the worst ever A&E waiting times and the longest NHS treatment waiting list in the same month shows a complete lack of leadership." Read full story. Source: BBC News, 19 August 2021 Related Reading Patient Safety Learning blog: Tackling the care and treatment backlog safely (19 August 2021)

New figures show a record number of 5.45 million people are waiting for NHS hospital treatment in England, with many more joining the waiting list who also need treatment, and those who came back to the NHS for healthcare having not done so during the worst periods of the pandemic. Sajid Javid, the Health Secretary has said, "We estimate there's probably some seven million people that ordinarily would have come forward to the NHS that stayed away, understandably, during the height of the pandemic. We want those people to come back. I don't know how many will come back but, even if half of them came to the NHS - and can I just stress I really want people that need to be seen by the NHS to know the NHS is there for them and they should come forward - but as they do I think waiting lists will rise because there will be a huge increase in demand." Read full story. Source: BBC News, 12 August 2021

New data has revealed as many as 14 million people could be on NHS waiting lists in England by the autumn of 2022 unless action is taken now to avoid this outcome. The Royal College of Nursing has confirmed these latest figures confirmed the “immense task that lies ahead” for the profession saying that more investment is needed to help tackle the waiting list crisis. In response to the analysis, Patricia Marquis, RCN England director, said: “These figures confirm the immense task that lies ahead for health and care services in recovering from the pandemic.” Read full story. Source: Nursing Times, 9 August 2021

According to the British Heart Foundation, it may take up to five years for cardiac services to return to pre-Covid levels. This warning comes after it was revealed nearly 14 million people could be on NHS waiting lists in England by next autumn. "Tragically, we have already seen thousands of extra deaths from heart and circulatory diseases during the pandemic, and delays to care have likely contributed to this terrible toll. At this critical moment, the government must act now to avoid more lives lost to treatable heart conditions. Addressing the growing heart care backlog is only the start," says Prof Samani, medical director at the British Heart Foundation. Read full story. Source: BBC News, 9 August 2021

This article by The Telegraph describes how average waiting times for 4.2 million people on the total NHS waiting lists has reached 37 weeks, with analysis showing patients are waiting twice as long as they were before the pandemic. Read full story (paywalled). Source: The Telegraph, 22 July 2021

NHS Blood and Transplant have estimated that almost 7,000 people are waiting for lifesaving transplants in the UK, the highest number in six years. During the first peak of the pandemic last year, several key services have had to be closed reveals the analysis from April 2020 to March 2021, although most were rapidly reinstated and 80% of NHS transplant work went ahead. Figures from the report found 474 patients died while waiting for organs, a higher number than the year before and the majority of patients were waiting for kidney transplants. Read full story. Source: BBC News, 15 July 2021

Health secretary Sajid Javid has warned NHS waiting lists will soar amid the incoming third wave of coronavirus. Thousands of patients are on hold for at least 2 minutes before their 999 calls are answered, The Independent has revealed. Mr Javid has also been told by officials the situation will get worse in the coming weeks. Speaking to the Sunday Telegraph, Mr Javid has said "Hearing that figure of 13 million, it has absolutely focused my mind, and it’s going to be one of my top priorities to deal with because we can’t have that." Read full story. Source: The Independent, 11 July 2021